Broad-spectrum Antibiotics Overused, Studies Say

Research from organizations including the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) urges doctors to limit the use of broad-spectrum antibiotics like Cipro (ciprofloxacin).

Recent studies have shown that doctors are overprescribing broad-spectrum antibiotics, which kill a wide swath of both good and bad bacteria in the body, according to the Wall Street Journal. Many infections, researchers say, can be treated with narrow-spectrum antibiotics, like penicillin, amoxicillin and cephalexin, which target a smaller number of bacteria.

Overuse of antibiotics, and prescribing broad-spectrum drugs when they aren’t needed, can cause a range of problems, according to the WSJ. The overused drugs become less effective against the bacteria they are intended to treat by fostering the growth of antibiotic-resistant infections. And the “big guns” like Cipro and Zithromax can wipe out the good bacteria that help the body digest food, produce vitamins, and protect from infections.

Researchers from the University of Utah and the CDC found that 60 percent of the cases where physicians prescribe antibiotics they choose broad-spectrum ones, according to the WSJ. Adam Hersh, assistant professor of pediatrics at University of Utah and a study author said broad-spectrum antibiotics are used both in situations where a narrower alternative would be appropriate and where no therapy is indicated.

The study relied on a public database of information from nearly 240,000 doctor’s office and emergency department visits. Doctors prescribed the stronger antibiotics for conditions including skin infections, urinary-tract infections, and respiratory problems. The study was published in July in the Journal of Antimicrobial Chemotherapy. A similar study published in 2011 in the journal Pediatrics found that broad-spectrum antibiotics were prescribed 50 percent of the time, mainly for respiratory conditions. About 25 percent of the time antibiotics were prescribed for conditions, such as viral infections, in which they have no use.

Broad-spectrum antibiotics are often prescribed when the doctor doesn’t know what bacteria strain is causing the infection. But testing can delay treatment a day or more, and, during the wait, there is the risk the infection will spread. Further, a patient in discomfort may not want to wait for test results.

Experts say broad-spectrum antibiotics are best reserved for severe conditions and for patients for whom multiple courses of antibiotics didn’t work, according to the WSJ. The American Academy of Pediatrics emphasizes the judicious use of antibiotics and this year updated its guidelines for treating sinusitis and ear infections. Both updates recommended the narrow-spectrum drug amoxicillin as a first-line treatment when an antibiotic is warranted.